The association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study.
The association between midlife blood pressure levels and late-life cognitive function. The Honolulu-Asia Aging Study.
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DOI：
10.1001/jama.1995.03530230032026
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发表时间：
1995-12
期刊：
影响因子：
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通讯作者：
L. Launer;K. Masaki;H. Petrovitch;D. Foley;R. Havlik
中科院分区：
文献类型：
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作者：
L. Launer;K. Masaki;H. Petrovitch;D. Foley;R. Havlik
目的评估中年血压水平与晚年认知功能的长期关系。设计：前瞻性檀香山心脏计划（基线，1965-1968）的4678名存活队列成员在1991年至1993年进行了第四次检查，并进行了认知测试。研究对象为居住在夏威夷社区或机构的3735名日裔美国男性，第四次检查时平均年龄为78岁。主要观察指标：认知功能，由100点认知能力筛选仪器（CASI）测量，分为良好（参考：CASI评分为92至100），中间（或= 160毫米汞柱;和DBP，或= 95毫米汞柱。结果当我们控制年龄和教育时，随着中年SBP类别水平的增加，中度和不良认知功能的风险逐渐增加（P趋势分别< .03和< .001）。SBP每增加10 mm Hg，中度认知功能风险增加7%（95%置信区间[CI]，3%-11%），认知功能不良风险增加9%（95% CI，3%-16%）。校正流行性卒中、冠心病和亚临床动脉粥样硬化后，中年SBP与认知功能不良之间的关系强度降低至5%（95%CI，0%-12%）。认知功能水平与中年DBP无关。结论：中年SBP是晚年认知功能下降的重要预测因子。早期控制SBP水平可能会降低老年认知功能障碍的风险。
OBJECTIVE To assess the long-term relationship of midlife blood pressure levels to late-life cognitive function. DESIGN The 4678 surviving cohort members of the prospective Honolulu Heart Program (baseline, 1965-1968) were examined a fourth time in 1991 through 1993 and given a cognitive test. PARTICIPANTS The subjects were 3735 Japanese-American men living in Hawaii in the community or in institutions, with an average age of 78 years at the fourth examination. MAIN OUTCOME MEASURES Cognitive function, measured by the 100-point Cognitive Abilities Screening Instrument (CASI), was categorized into good (reference: a CASI score of 92 to 100), intermediate ( or = 160 mm Hg; and for DBP, or = 95 mm Hg. RESULTS When we controlled for age and education, the risk for intermediate and poor cognitive function increased progressively with increasing level of midlife SBP category (P for trend < .03 and < .001, respectively). For every 10-mm Hg increase in SBP there was an increase in risk for intermediate cognitive function of 7% (95% confidence interval [CI], 3% to 11%) and for poor cognitive function of 9% (95% CI, 3% to 16%). Adjustment for prevalent stroke, coronary heart disease, and subclinical atherosclerosis reduced the strength of the relationship between midlife SBP and poor cognitive function to 5% (95% CI, 0% to 12%). The level of cognitive function was not associated with midlife DBP. CONCLUSIONS Midlife SBP is a significant predictor of reduced cognitive function in later life. Early control of SBP levels may reduce the risk for cognitive impairment in old age.